Individual
PAUL EDWARD CULLUM
Active
Individual
PAUL EDWARD CULLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS3661
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010342
TENNCARE
TN
01
—
3072215
BLUE CROSS BLUE SHIELD TN
TN
01
—
80-40025
UNITED HEALTHCARE
TN
01
—
909843
UNITED CONCORDIA
TN
Enumeration date
07/26/2006
Last updated
11/11/2011
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